Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel
© 2024 The Authors..
Introduction: Planning cranioplasty (CPL) in patients with suspected or proven post-traumatic hydrocephalus (PTH) poses a significant management challenge due to a lack of clear guidance.
Research question: This project aims to create a European document to improve adherence and adapt to local protocols based on available resources and national health systems.
Methods: After a thorough non-systematic review, a steering committee (SC) formed a European expert panel (EP) for a two-round questionnaire using the Delphi method. The questionnaire employed a 9-point Likert scale to assess the appropriateness of statements inherent to two sections: "Diagnostic criteria for PTH" and "Surgical strategies for PTH and cranial reconstruction.".
Results: The panel reached a consensus on 29 statements. In the "Diagnostic criteria for PTH" section, five statements were deemed "appropriate" (consensus 74.2-90.3 %), two were labeled "inappropriate," and seven were marked as "uncertain."In the "Surgical strategies for PTH and cranial reconstruction" section, four statements were considered "appropriate" (consensus 74.2-90.4 %), six were "inappropriate," and five were "uncertain.".
Discussion and conclusion: Planning a cranioplasty alongside hydrocephalus remains a significant challenge in neurosurgery. Our consensus conference suggests that, in patients with cranial decompression and suspected hydrocephalus, the most suitable diagnostic approach involves a combination of evolving clinical conditions and neuroradiological imaging. The recommended management sequence prioritizes cranial reconstruction, with the option of a ventriculoperitoneal shunt when needed, preferably with a programmable valve. We strongly recommend to adopt local protocols based on expert consensus, such as this, to guide patient care.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:4 |
|---|---|
| Enthalten in: |
Brain & spine - 4(2024) vom: 09., Seite 102761 |
| Sprache: |
Englisch |
|---|
| Links: |
|---|
| Themen: |
Cranioplasty |
|---|
| Anmerkungen: |
Date Revised 22.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.bas.2024.102761 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM370002245 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM370002245 | ||
| 003 | DE-627 | ||
| 005 | 20240323001536.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240322s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.bas.2024.102761 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1341.xml |
| 035 | |a (DE-627)NLM370002245 | ||
| 035 | |a (NLM)38510640 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Iaccarino, Corrado |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 22.03.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2024 The Authors. | ||
| 520 | |a Introduction: Planning cranioplasty (CPL) in patients with suspected or proven post-traumatic hydrocephalus (PTH) poses a significant management challenge due to a lack of clear guidance | ||
| 520 | |a Research question: This project aims to create a European document to improve adherence and adapt to local protocols based on available resources and national health systems | ||
| 520 | |a Methods: After a thorough non-systematic review, a steering committee (SC) formed a European expert panel (EP) for a two-round questionnaire using the Delphi method. The questionnaire employed a 9-point Likert scale to assess the appropriateness of statements inherent to two sections: "Diagnostic criteria for PTH" and "Surgical strategies for PTH and cranial reconstruction." | ||
| 520 | |a Results: The panel reached a consensus on 29 statements. In the "Diagnostic criteria for PTH" section, five statements were deemed "appropriate" (consensus 74.2-90.3 %), two were labeled "inappropriate," and seven were marked as "uncertain."In the "Surgical strategies for PTH and cranial reconstruction" section, four statements were considered "appropriate" (consensus 74.2-90.4 %), six were "inappropriate," and five were "uncertain." | ||
| 520 | |a Discussion and conclusion: Planning a cranioplasty alongside hydrocephalus remains a significant challenge in neurosurgery. Our consensus conference suggests that, in patients with cranial decompression and suspected hydrocephalus, the most suitable diagnostic approach involves a combination of evolving clinical conditions and neuroradiological imaging. The recommended management sequence prioritizes cranial reconstruction, with the option of a ventriculoperitoneal shunt when needed, preferably with a programmable valve. We strongly recommend to adopt local protocols based on expert consensus, such as this, to guide patient care | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cranioplasty | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a Post-traumatic hydrocephalus | |
| 650 | 4 | |a Surgical strategy | |
| 700 | 1 | |a Chibbaro, Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Sauvigny, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Timofeev, Ivan |e verfasserin |4 aut | |
| 700 | 1 | |a Zaed, Ismail |e verfasserin |4 aut | |
| 700 | 1 | |a Franchetti, Silvio |e verfasserin |4 aut | |
| 700 | 1 | |a Mee, Harry |e verfasserin |4 aut | |
| 700 | 1 | |a Belli, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Buki, Andras |e verfasserin |4 aut | |
| 700 | 1 | |a De Bonis, Pasquale |e verfasserin |4 aut | |
| 700 | 1 | |a Demetriades, Andreas K |e verfasserin |4 aut | |
| 700 | 1 | |a Depreitere, Bart |e verfasserin |4 aut | |
| 700 | 1 | |a Fountas, Kostantinos |e verfasserin |4 aut | |
| 700 | 1 | |a Ganau, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Germanò, Antonino |e verfasserin |4 aut | |
| 700 | 1 | |a Hutchinson, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Kolias, Angelos |e verfasserin |4 aut | |
| 700 | 1 | |a Lindner, Dirk |e verfasserin |4 aut | |
| 700 | 1 | |a Lippa, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Marklund, Niklas |e verfasserin |4 aut | |
| 700 | 1 | |a McMahon, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Mielke, Dorothee |e verfasserin |4 aut | |
| 700 | 1 | |a Nasi, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a Peul, Wilco |e verfasserin |4 aut | |
| 700 | 1 | |a Poca, Maria Antonia |e verfasserin |4 aut | |
| 700 | 1 | |a Pompucci, Angelo |e verfasserin |4 aut | |
| 700 | 1 | |a Posti, Jussi P |e verfasserin |4 aut | |
| 700 | 1 | |a Serban, Nicoleta-Larisa |e verfasserin |4 aut | |
| 700 | 1 | |a Splavski, Bruno |e verfasserin |4 aut | |
| 700 | 1 | |a Florian, Ioan Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Tasiou, Anastasia |e verfasserin |4 aut | |
| 700 | 1 | |a Zona, Gianluigi |e verfasserin |4 aut | |
| 700 | 1 | |a Servadei, Franco |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Brain & spine |d 2021 |g 4(2024) vom: 09., Seite 102761 |w (DE-627)NLM347623549 |x 2772-5294 |7 nnns |
| 773 | 1 | 8 | |g volume:4 |g year:2024 |g day:09 |g pages:102761 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.bas.2024.102761 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 4 |j 2024 |b 09 |h 102761 | ||